Incidence and Risk Factors for Intensive Care Unit-related Post-traumatic Stress Disorder in Veterans and Civilians

Am J Respir Crit Care Med. 2016 Jun 15;193(12):1373-81. doi: 10.1164/rccm.201506-1158OC.

Abstract

Rationale: The incidence and risk factors of post-traumatic stress disorder (PTSD) related to the intensive care unit (ICU) experience have not been reported in a mixed veteran and civilian cohort.

Objectives: To describe the incidence and risk factors for ICU-related PTSD in veterans and civilians.

Methods: This is a prospective, observational, multicenter cohort enrolling adult survivors of critical illness after respiratory failure and/or shock from three Veterans Affairs and one civilian hospital. After classifying those with/without preexisting PTSD (i.e., PTSD before hospitalization), we then assessed all subjects for ICU-related PTSD at 3 and 12 months post hospitalization.

Measurements and main results: Of 255 survivors, 181 and 160 subjects were assessed for ICU-related PTSD at 3- and 12-month follow-up, respectively. A high probability of ICU-related PTSD was found in up to 10% of patients at either follow-up time point, whether assessed by PTSD Checklist Event-Specific Version (score ≥ 50) or item mapping using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). In the multivariable regression, preexisting PTSD was independently associated with ICU-related PTSD at both 3 and 12 months (P < 0.001), as was preexisting depression (P < 0.03), but veteran status was not a consistent independent risk factor for ICU-related PTSD (3-month P = 0.01, 12-month P = 0.48).

Conclusions: This study found around 1 in 10 ICU survivors experienced ICU-related PTSD (i.e., PTSD anchored to their critical illness) in the year after hospitalization. Preexisting PTSD and depression were strongly associated with ICU-related PTSD.

Keywords: intensive care unit; post-traumatic stress disorder; veterans.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Cohort Studies
  • Critical Care / psychology
  • Critical Illness / psychology
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Incidence
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology*
  • Survivors / psychology
  • Survivors / statistics & numerical data
  • Veterans / psychology*
  • Veterans / statistics & numerical data*